New Hampshire Medicaid

New Hampshire Medicaid is a federal and state-funded insurance program that serves individuals and families who meet financial and other eligibility requirements. Medicaid for children ages 0-19 provides a full range of health and dental services to eligible children at no cost to the family. Children receive care from doctors, dentists, and healthcare providers contracted by Medicaid.

The Bureau of Family Assistance (BFA) determines Medicaid financial eligibility and all non-financial eligibility, except medical necessity determinations, for the following groups: children under the age of 19, pregnant women, low-income families with children, individuals who are blind, refugees, non-citizens, seniors, and adults with disabilities.

Eligibilities

  • Income
  • Resources — for the non-modified adjusted gross income (MAGI) groups only
  • non-financial criteria
    • While non-financial information is generally the same for each, there are some differences. For example, an application for services under the Aid to the Needy Blind program requires an individual to have a medical necessity determination of being legally blind. In contrast, an application for services for seniors has no medical necessity requirement but does have an age requirement.

Types of Medicaid

Children’s Medicaid & Children’s Expanded Medicaid – Children’s Medicaid (CM)

Children’s Medicaid provides free health and dental coverage for children up to age 20 with family income less than or equal to 196% of the federal poverty income limit. Children’s Expanded Medicaid covers children up to age 19, and the financial eligibility is 196% up to but not more than 318% of the federal poverty income limits.

Categorical eligibility for children and young adults with disabilities

  • Home Care for Children with Severe Disabilities (HCCSD), often called “Katie Beckett.”
    • For children with severe disabilities up to age 19 whose medical/behavioral disability is so severe that they qualify under a medical determination for Social Security Supplemental Income eligibility and for institutional level of care but who are being cared for at home. Only the income and resources of the child are counted towards eligibility for this program.
  • Aid to the Needy Blind (ANB)
    • A category of eligibility requires an individual (child or adult) to be diagnosed as legally blind. The visual acuity in the better eye can be no greater than 20/200.
  • Aid To The Permanently and Totally Disabled (APTD)
    • When a person turns 18 years old, Medicaid considers them an adult. Eligibility for Medicaid is based on income, assets, and medical condition. An adult applying for Medicaid must have a severe, impairing health condition that has lasted and is expected to last for a minimum of 48 months (4 years) and have income levels at or below the poverty level with assets (savings account, trust, etc.) below $2,500. If a person is working and their income is too high for this program but still qualifies medically, they may qualify for MEAD.
  • Medicaid for Employed Adults with Disabilities or MEAD :
    • Medicaid for Employed Adults with Disabilities (MEAD) provides Medicaid coverage to working adults with disabilities who would not otherwise be financially eligible for Medicaid. MEAD was designed to allow individuals with disabilities to increase their working income and have higher resource limits.

Applying for New Hampshire Medicaid

The Division of Family Assistance offers NH EASY, New Hampshire’s Electronic Application System. You can apply or reapply for assistance, check eligibility, report changes, and track your application status by visiting the NH EASY web page. Applications can also be made at field offices called NHDHHS District Offices.

When you receive Medicaid

Once you have been found eligible for Medicaid, you will be required to participate in a Care Management program. NHDHHS, Medicaid, uses three Care Management Health Plans. Each Health Plan has its own network of doctors, nurses, and other providers. These health plans cover the same services that NH Medicaid does, and they also offer optional services, programs, and other extras, including wellness and prevention programs.

You will be asked to pick from these Health Plans:

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